<script type="text/html" id="tpl_csgl">
<div class="public-tpl-row1">
    <form class="layui-form" id="tpl_csgl_form" action="{:url('index/dictionary.manufacturer/info')}">
    	<input type="hidden" name="id" value="" autocomplete="off" class="layui-input">
    	<fieldset class="layui-elem-field layui-field-title"><legend>基本信息</legend></fieldset>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label" id="tpl_csgl_label"><i class="c-red">*</i>厂商名称</label>
				<div class="layui-input-inline">
				<input type="text" name="name" maxlength="30" autocomplete="off" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">厂商简称</label>
				<div class="layui-input-inline">
				<input type="text" name="short_name" maxlength="30" autocomplete="off" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label"><i class="c-red">*</i>厂商编码</label>
				<div class="layui-input-inline">
				<input type="text" name="bianma" maxlength="20" autocomplete="off" class="layui-input">
				</div>
			</div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label">厂商类型</label>
				<div class="layui-input-inline">
					<select name="cs_type">
		        		{volist name="cs_type_list" id="lx"}
	                        <option value="{$lx.id}">{$lx.name}</option>
	                    {/volist}
	                </select>
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">产品类型</label>
				<div class="layui-input-inline">
					<select name="cp_type">
		        		{volist name="cscp_type_list" id="cp"}
	                        <option value="{$cp.id}">{$cp.name}</option>
	                    {/volist}
	                </select>
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">营业执照号</label>
				<div class="layui-input-inline">
				<input type="text" name="zhizhao_no" maxlength="30" autocomplete="off" class="layui-input">
				</div>
			</div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label">拼音简码</label>
				<div class="layui-input-inline">
				<input type="text" name="py_code" maxlength="20" autocomplete="off" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">五笔简码</label>
				<div class="layui-input-inline">
				<input type="text" name="wb_code" maxlength="20" autocomplete="off" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">联系电话</label>
				<div class="layui-input-inline">
				<input type="text" name="tel" maxlength="20" autocomplete="off" class="layui-input">
				</div>
			</div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label">国家</label>
				<div class="layui-input-inline">
					<select name="country" class="country" lay-filter="country">
		        		<option value="国内">国内</option>
		        		<option value="国外">国外</option>
	                </select>
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">省份</label>
				<div class="layui-input-inline">
					<select name="province" class="province" lay-filter="province" lay-search></select>
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">城市</label>
				<div class="layui-input-inline">
					<select name="city" class="city" lay-filter="city" lay-search></select>
				</div>
			</div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">详细地址</label>
            <div class="layui-input-block" style="width:820px;">
            	<input type="text" name="address" maxlength="100" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label">备注</label>
				<div class="layui-input-inline" style="width:503px;">
				<input type="text" name="remarks" maxlength="200" autocomplete="off" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label">启用标志</label>
				<div class="layui-input-inline">
				<input type="radio" name="status" value="1" title="已启用" checked>
	            <input type="radio" name="status" value="0" title="已停用">
				</div>
			</div>
        </div>
        <fieldset class="layui-elem-field layui-field-title"><legend>经营许可信息</legend></fieldset>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label" style="width:129px;">经营许可证号</label>
				<div class="layui-input-inline" style="width:300px;">
				<input type="text" name="jyxk_no" maxlength="100" autocomplete="off" placeholder="经营许可证编号" class="layui-input">
				</div>
			</div>
			<div class="layui-inline"><label class="layui-form-label" style="width:129px;">GSP证书编号</label>
				<div class="layui-input-inline" style="width:300px;">
				<input type="text" name="gsp_no" maxlength="100" autocomplete="off" placeholder="GSP认证证书编号" class="layui-input">
				</div>
			</div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label" style="width:129px;">医疗器械注册证号</label>
				<div class="layui-input-inline" style="width:254px;">
				<input type="text" name="ylqx_no" maxlength="100" autocomplete="off" placeholder="医疗器械注册证号" class="layui-input">
				</div>
			</div>
			<div class="layui-inline">
				<div class="layui-input-inline" style="width:245px;">
				<input type="text" name="ylqx_no1" autocomplete="off" placeholder="" class="layui-input">
				</div>
			</div>
			<div class="layui-inline">
				<div class="layui-input-inline" style="width:245px;">
				<input type="text" name="ylqx_no2" maxlength="100" autocomplete="off" placeholder="" class="layui-input">
				</div>
			</div>
        </div>
        <div class="layui-form-item">
			<div class="layui-inline"><label class="layui-form-label" style="width:129px;">产品检验报告编号</label>
				<div class="layui-input-inline" style="width:254px;">
				<input type="text" name="cpjybg_no" maxlength="100" autocomplete="off" placeholder="产品检验报告编号" class="layui-input">
				</div>
			</div>
			<div class="layui-inline">
				<div class="layui-input-inline" style="width:245px;">
				<input type="text" name="cpjybg_no1" maxlength="100" autocomplete="off" placeholder="" class="layui-input">
				</div>
			</div>
			<div class="layui-inline">
				<div class="layui-input-inline" style="width:245px;">
				<input type="text" name="cpjybg_no2" maxlength="100" autocomplete="off" placeholder="" class="layui-input">
				</div>
			</div>
        </div>
    </form>
</div>
</script>